Retrograde nailing of femoral fractures: a retrospective study

Shah, Sagar; Desai, Pingal; Mounasamy, Varatharaj

doi:10.1007/s00590-015-1658-6

Cited by 22 publications

(19 citation statements)

References 30 publications

(43 reference statements)

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“… 6 , 9 Indications for the retrograde use of the implant include possible simultaneous fixation in the same operative field in cases of bilateral femoral fractures or simultaneous proximal/diaphyseal fractures using two implants, in addition to stabilization of floating knee using the same access path, shorter surgical time due to less manipulation required to position the patient, and the possibility of performing the procedure on a radiotransparent table, in case of polytraumatized patients. 5 , 7 In terms of consolidation rates and complications, both techniques present similar clinical outcomes according to the literature. 1 , 2 , 9 …”

Section: Introductionsupporting

confidence: 58%

“…Intramedullary nails can be inserted by a proximal (antegrade) or distal (retrograde) approach. 4 , 5 Disadvantages of the proximal approach include difficult insertion of the stem in obese patients and risks of femoral head necrosis or fracture, implant-related pain, gluteus medius insufficiency, and heterotopic ossification around the hip. 6 , 7 Disadvantages of the distal approach include the need to open the joint to introduce the nail, knee pain, mobility restriction, iatrogenic injury to the anterior cruciate ligament, and risk of septic arthritis.…”

Section: Introductionmentioning

confidence: 99%

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Antegrade X Retrograde Nailing in Femoral Fractures: A Study on Consolidation and Infection

et al. 2019

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Objective:Osteosynthesis with intramedullary nailing is considered the method of choice to treat diaphyseal femur fractures in adults. The objective of this retrospective study was to evaluate the bone healing time and incidence of infection in patients with diaphyseal femur fractures treated surgically with retrograde and antegrade intramedullary nailing.Methods:The medical records of 123 patients from two university hospitals dated 2011-2013 were evaluated, with 126 diaphyseal femur fractures having been found. The most frequent treatment was antegrade intramedullary nailing (51%), of which 38% involved reaming (n=25).Results:We found evidence of 92% healed fractures at 12 months postoperatively. Complications included chronic osteomyelitis in one patient and femoral neck fracture in another patient, both after reamed antegrade nailing. Pyoarthritis of the knee associated with osteomyelitis affected two patients after reamed retrograde nailing and one patient after unreamed retrograde nailing.Conclusion:We did not observe a significant difference in bone healing rates with the use of reamed or unreamed antegrade or retrograde nailing. Complications included the presence of infection with an incidence similar to that reported in the literature, and of particular significance, unrelated to the type of approach. Level of evidence III, Retrospective comparative study.

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Section: Introductionsupporting

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Antegrade X Retrograde Nailing in Femoral Fractures: A Study on Consolidation and Infection

et al. 2019

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“…15 Other problems include anterior knee pain in 22%, locking screws missing the nail up to 12%, locking screw breakage in up to 8%, implant failure up to 6%, loss of reduction in 7%, nail protrusion into knee in 2% andfemoral shaft fracture during reaming 2%. [15,16,17,18,19] Retrograde femoral nailing is an effective method of femoral shaft fracture fixation in polytrauma patients. The healing rate of femoral shaft fractures fixed with a retrograde nail is the same regardless of location of fracture, age, sex, or comminution.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of short term complications following use of retrograde intramedullary femoral interlocking nail for fractures of distal femur

Yogi¹,

Mahi²,

Lokhande³

2020

Int. J. Orthop. Sci.

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Background: Supracondylar fractures of femur constitute 6-7% of all femoral fractures. In elderly patients, they are invariably low-energy fractures predisposed by osteoporosis. Aim of this article is to assess the complications of retrograde intramedullary femoral interlocking nail (RIFIN). Materials and methods: The study was conducted at a tertiary health care centre, cases were selected from November 2017 to December 2018. This prospective study was performed on 37 patients with supracondylar femoral fractures (AO type A and C). Results: Complications in our study included knee stiffness in 8 patients, anterior knee pain in 6 patients, shortening (1-2cm) in 3 patients, 3 patients had implant failure due to early weight bearing ambulation (one patient had distal screw back-out, one patient distal screw breakage and one patient had nail breakage), 2 patients had non-union (in which one patient had infected non-union), one patient had periimplant fracture and one patient had protruding nail. Conclusion: RIFIN is mostly limited for use in extra-articular distal femoral fractures. Although it has a high incidence of complications, it requires a greater amount of attention to the operative technique and patient selection in order to prevent these complications.

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“…Whether IM nails should be placed antegrade or retrograde is debatable and is not discussed in the cited instructional reviews. In trauma surgery, (reamed) antegrade and retrograde placed nails for distal femur fractures have shown comparable results regarding union and complications . These results are however difficult to translate to the (impending) pathologic fracture population.…”

Section: Discussionmentioning

confidence: 99%

Pathologic fractures of the distal femur: Current concepts and treatment options

Willeumier

Wal

Schoones

et al. 2018

Journal of Surgical Oncology

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Pathologic fractures of the distal femur caused by bone metastases are not as common as those in the proximal femur but provide great difficulty to adequately treat. This systematic review shows that insufficient literature exists to draw clinically relevant conclusions for essential questions, such as “what factors indicate an endoprosthetic reconstruction for distal femur pathologic fractures?” Due to paucity of literature in the systematic review, a current concepts review (including treatment flowchart), based on instructional reviews and experience, was also performed.

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Retrograde nailing of femoral fractures: a retrospective study

Cited by 22 publications

References 30 publications

Antegrade X Retrograde Nailing in Femoral Fractures: A Study on Consolidation and Infection

Antegrade X Retrograde Nailing in Femoral Fractures: A Study on Consolidation and Infection

Evaluation of short term complications following use of retrograde intramedullary femoral interlocking nail for fractures of distal femur

Pathologic fractures of the distal femur: Current concepts and treatment options

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